1
|
Zhang J, Wang G, Li Z, Pang G. Advanced perioperative assessment of neurological function in acute Stanford A aortic dissection. Int J Neurosci 2024:1-11. [PMID: 38682651 DOI: 10.1080/00207454.2024.2346152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 04/17/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE Acute Stanford Type A aortic dissection (AAAD) is a critical condition in vascular surgery, and total aortic arch replacement surgery is the preferred method to save patients' lives. In recent years, as clinical research has advanced, there has been a growing realization of the close association between poor postoperative outcomes in patients and neurological functional deficits. Neurological function monitoring is a medical technique used to evaluate and monitor the functional status of the nervous system. METHODS This monitoring involves the assessment of various aspects of the nervous system, including but not limited to nerve conduction velocity, neuromuscular function, electroencephalographic activity, and sensory nerve transmission. Neurological function monitoring has broad clinical applications and can be used to diagnose and monitor many neurological disorders, helping physicians understand patients' neurological functional status and guide treatment plans. During the postoperative recovery process, neurological function monitoring can assist physicians in assessing the potential impact of surgery on the nervous system and monitor the recovery of patients' neurological function. RESULTS Studies have shown that neurological function monitoring holds promise in predicting neurological functional prognosis and interventions for patients with aortic dissection. CONCLUSION Therefore, the primary objective of this study is to evaluate the effectiveness and reliability of various intraoperative neurological monitoring techniques, neuroimaging examinations, and biomarkers in predicting and assessing postoperative neurological outcomes in patients undergoing AAAD surgery.
Collapse
Affiliation(s)
- Jinpeng Zhang
- Department of Cardiothoracic Surgery, Jincheng People's Hospital, Jincheng Hospital Affiliated to Changzhi Medical College, Jincheng, China
| | - Guangjun Wang
- Department of Cardiothoracic Surgery, Jincheng People's Hospital, Jincheng Hospital Affiliated to Changzhi Medical College, Jincheng, China
| | - Zhongping Li
- Department of Critical Care Medicine, Jincheng People's Hospital, Jincheng Hospital Affiliated to Changzhi Medical College, Jincheng, China
| | - Guofen Pang
- Department of Critical Care Medicine, Jincheng People's Hospital, Jincheng Hospital Affiliated to Changzhi Medical College, Jincheng, China
| |
Collapse
|
2
|
Brito R, Fabrício JV, Araujo A, Barreto G, Baltar A, Monte-Silva K. Single-Session Cerebellar Transcranial Direct Current Stimulation Improves Postural Stability and Reduces Ataxia Symptoms in Spinocerebellar Ataxia. CEREBELLUM (LONDON, ENGLAND) 2024:10.1007/s12311-024-01696-9. [PMID: 38693314 DOI: 10.1007/s12311-024-01696-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/20/2024] [Indexed: 05/03/2024]
Abstract
Spinocerebellar ataxia (SCA) results in balance and coordination impairment, and current treatments have limited efficacy. Recent evidence suggests that combining postural training with cerebellar transcranial direct current stimulation (ctDCS) can improve these symptoms. However, the combined effects of ctDCS and postural training on individuals with spinocerebellar ataxia remain underexplored. Ten volunteers with (SCA type 3) participated in a triple-blind, randomized, crossover study to receive a single session of ctDCS (2 mA for 20 min) and a sham ctDCS session separated by at least one week. The Biodex Balance System was used to assess balance at each session, measuring overall stability index, anteroposterior stability index, and medial-lateral stability index. As secondary outcomes, cerebellar ataxia symptoms were evaluated using the 8-item Scale for Assessment and Rating of Ataxia. The assessments were conducted before and after each session. The results indicated that ctDCS enhanced the overall stability index when compared to sham ctDCS (Z = -2.10, p = 0.03), although it did not significantly affect the anteroposterior or medial-lateral stability indices. Compared to the baseline, a single session of ctDCS reduced appendicular symptoms related to cerebellar ataxia, as evidenced by improvements in the nose-finger test (Z = -2.07, p = 0.04), fast alternating hand movements (Z = -2.15, p = 0.03), and heel-to-shin slide (Z = -1.91, p = 0.05). In conclusion, our study suggests that a single session of ctDCS, in combination with postural training, can enhance balance and alleviate ataxia symptoms in individuals with cerebellar ataxia. This study was approved by the local research ethics committee (No. 2.877.813) and registered on clinicaltrials.org (NCT04039048 - https://www.clinicaltrials.gov/study/NCT04039048 ) on 2019-07-28.
Collapse
Affiliation(s)
- Rodrigo Brito
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Jornalista Aníbal Fernandes Avenue, Recife, 50740-560, PE, Brasil
- NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Palmares, Pernambuco, Brazil
| | - João Victor Fabrício
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Jornalista Aníbal Fernandes Avenue, Recife, 50740-560, PE, Brasil
| | - Aurine Araujo
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Jornalista Aníbal Fernandes Avenue, Recife, 50740-560, PE, Brasil
| | - Gabriel Barreto
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Jornalista Aníbal Fernandes Avenue, Recife, 50740-560, PE, Brasil
- NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Palmares, Pernambuco, Brazil
| | - Adriana Baltar
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Jornalista Aníbal Fernandes Avenue, Recife, 50740-560, PE, Brasil
- NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Palmares, Pernambuco, Brazil
| | - Kátia Monte-Silva
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Jornalista Aníbal Fernandes Avenue, Recife, 50740-560, PE, Brasil.
- NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Palmares, Pernambuco, Brazil.
| |
Collapse
|
3
|
Leung TCS, Fields E, Rana N, Shen RYL, Bernstein AE, Cook AA, Phillips DE, Watt AJ. Mitochondrial damage and impaired mitophagy contribute to disease progression in SCA6. Acta Neuropathol 2024; 147:26. [PMID: 38286873 PMCID: PMC10824820 DOI: 10.1007/s00401-023-02680-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/18/2023] [Accepted: 12/27/2023] [Indexed: 01/31/2024]
Abstract
Spinocerebellar ataxia type 6 (SCA6) is a neurodegenerative disease that manifests in midlife and progressively worsens with age. SCA6 is rare, and many patients are not diagnosed until long after disease onset. Whether disease-causing cellular alterations differ at different disease stages is currently unknown, but it is important to answer this question in order to identify appropriate therapeutic targets across disease duration. We used transcriptomics to identify changes in gene expression at disease onset in a well-established mouse model of SCA6 that recapitulates key disease features. We observed both up- and down-regulated genes with the major down-regulated gene ontology terms suggesting mitochondrial dysfunction. We explored mitochondrial function and structure and observed that changes in mitochondrial structure preceded changes in function, and that mitochondrial function was not significantly altered at disease onset but was impaired later during disease progression. We also detected elevated oxidative stress in cells at the same disease stage. In addition, we observed impairment in mitophagy that exacerbates mitochondrial dysfunction at late disease stages. In post-mortem SCA6 patient cerebellar tissue, we observed metabolic changes that are consistent with mitochondrial impairments, supporting our results from animal models being translatable to human disease. Our study reveals that mitochondrial dysfunction and impaired mitochondrial degradation likely contribute to disease progression in SCA6 and suggests that these could be promising targets for therapeutic interventions in particular for patients diagnosed after disease onset.
Collapse
Affiliation(s)
| | - Eviatar Fields
- Department of Biology, McGill University, Montreal, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Namrata Rana
- Department of Biology, McGill University, Montreal, QC, Canada
| | | | | | - Anna A Cook
- Department of Biology, McGill University, Montreal, QC, Canada
| | | | - Alanna J Watt
- Department of Biology, McGill University, Montreal, QC, Canada.
| |
Collapse
|
4
|
Krupnik V. I like therefore I can, and I can therefore I like: the role of self-efficacy and affect in active inference of allostasis. Front Neural Circuits 2024; 18:1283372. [PMID: 38322807 PMCID: PMC10839114 DOI: 10.3389/fncir.2024.1283372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024] Open
Abstract
Active inference (AIF) is a theory of the behavior of information-processing open dynamic systems. It describes them as generative models (GM) generating inferences on the causes of sensory input they receive from their environment. Based on these inferences, GMs generate predictions about sensory input. The discrepancy between a prediction and the actual input results in prediction error. GMs then execute action policies predicted to minimize the prediction error. The free-energy principle provides a rationale for AIF by stipulating that information-processing open systems must constantly minimize their free energy (through suppressing the cumulative prediction error) to avoid decay. The theory of homeostasis and allostasis has a similar logic. Homeostatic set points are expectations of living organisms. Discrepancies between set points and actual states generate stress. For optimal functioning, organisms avoid stress by preserving homeostasis. Theories of AIF and homeostasis have recently converged, with AIF providing a formal account for homeo- and allostasis. In this paper, we present bacterial chemotaxis as molecular AIF, where mutual constraints by extero- and interoception play an essential role in controlling bacterial behavior supporting homeostasis. Extending this insight to the brain, we propose a conceptual model of the brain homeostatic GM, in which we suggest partition of the brain GM into cognitive and physiological homeostatic GMs. We outline their mutual regulation as well as their integration based on the free-energy principle. From this analysis, affect and self-efficacy emerge as the main regulators of the cognitive homeostatic GM. We suggest fatigue and depression as target neurocognitive phenomena for studying the neural mechanisms of such regulation.
Collapse
Affiliation(s)
- Valery Krupnik
- Department of Mental Health, Naval Hospital Camp Pendleton, Camp Pendleton, Oceanside, CA, United States
| |
Collapse
|
5
|
Jin P, Cui F, Xu M, Ren Y, Zhang L. Altered brain function and structure pre- and post- COVID-19 infection: a longitudinal study. Neurol Sci 2024; 45:1-9. [PMID: 38049550 DOI: 10.1007/s10072-023-07236-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/28/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Evidence indicates that the SARS-CoV-2 virus can infect the brain, resulting in central nervous system symptoms. However, there is a lack of a longitudinal imaging study investigating the impact of Coronavirus disease 2019 (COVID-19) infection on brain function. Consequently, this study aimed to fill this knowledge gap using functional magnetic resonance imaging (fMRI). METHODS Twenty-one participants underwent two resting-state fMRI scans before and after infection. The amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) were assessed to identify the brain function changes. Additionally, voxel-based morphometry (VBM) was utilized to assess changes in brain structure. Subsequently, brain regions that showed significant differences were identified as regions of interest (ROI) in functional connectivity analysis (FC). RESULTS After infection, ALFF was increased in the bilateral paracentral lobe and postcentral gyrus while decreased in the bilateral precuneus. Moreover, ReHo was decreased in the cerebellar vermis, accompanied by a decrease in FC with the bilateral postcentral gyrus. Furthermore, gray matter volume (GMV) reduction was observed in the left thalamus. The results of the correlation analysis revealed a negative correlation between ALFF values in the bilateral precuneus and scores on the self-rating anxiety scale (SAS) in pre- and post-infection datasets. CONCLUSION Neuroimaging alterations may occur before the manifestation of clinical symptoms, indicating that the functioning of the motor and sensory systems, as well as their connection, might be affected following infection. This alteration can potentially increase the potential of maladaptive responses to environmental stimuli. Furthermore, patients may be susceptible to future emotional disorders.
Collapse
Affiliation(s)
- Ping Jin
- Department of Radiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Stadium Road 453#, Xihu District, Hangzhou City, 310000, Zhejiang Province, China
| | - Feng Cui
- Department of Radiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Stadium Road 453#, Xihu District, Hangzhou City, 310000, Zhejiang Province, China
| | - Min Xu
- Department of Radiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Stadium Road 453#, Xihu District, Hangzhou City, 310000, Zhejiang Province, China
| | - Yue Ren
- Department of Radiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Stadium Road 453#, Xihu District, Hangzhou City, 310000, Zhejiang Province, China
| | - Luping Zhang
- Department of Radiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Stadium Road 453#, Xihu District, Hangzhou City, 310000, Zhejiang Province, China.
| |
Collapse
|
6
|
Takemi M, Akahoshi M, Ushiba J, Furuya S. Behavioral and physiological fatigue-related factors influencing timing and force control learning in pianists. Sci Rep 2023; 13:21646. [PMID: 38062126 PMCID: PMC10703774 DOI: 10.1038/s41598-023-49226-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023] Open
Abstract
Optimizing the training regimen depending on neuromuscular fatigue is crucial for the well-being of professionals intensively practicing motor skills, such as athletes and musicians, as persistent fatigue can hinder learning and cause neuromuscular injuries. However, accurate assessment of fatigue is challenging because of the dissociation between subjective perception and its impact on motor and cognitive performance. To address this issue, we investigated the interplay between fatigue and learning development in 28 pianists during three hours of auditory-motor training, dividing them into two groups subjected to different resting conditions. Changes in behavior and muscle activity during training were measured to identify potential indicators capable of detecting fatigue before subjective awareness. Our results indicate that motor learning and fatigue development are independent of resting frequency and timing. Learning indices, such as reduction in force and timing errors throughout training, did not differ between the groups. No discernible distinctions emerged in fatigue-related behavioral and physiological indicators between the groups. Regression analysis revealed that several fatigue-related indicators, such as tapping speed variability and electromyogram amplitude per unit force, could explain the learning of timing and force control. Our findings suggest the absence of a universal resting schedule for optimizing auditory-motor learning.
Collapse
Affiliation(s)
- Mitsuaki Takemi
- Graduate School of Science and Technology, Keio University, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa, 223-8522, Japan.
| | - Mai Akahoshi
- Sony Computer Science Laboratories, Inc., Tokyo, Japan
- Department of Biosciences and Informatics, Faculty of Science and Technology, Keio University, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa, 223-8522, Japan
| | - Junichi Ushiba
- Department of Biosciences and Informatics, Faculty of Science and Technology, Keio University, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa, 223-8522, Japan.
| | | |
Collapse
|
7
|
Azzollini V, Hayward W. What Role Does the Cerebellum Have in a Fatigue Network? J Neurosci 2023; 43:7599-7600. [PMID: 37940597 PMCID: PMC10634545 DOI: 10.1523/jneurosci.1168-23.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 11/10/2023] Open
Affiliation(s)
- Valentina Azzollini
- Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892
| | - William Hayward
- Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892
| |
Collapse
|
8
|
Matsugi A, Nishishita S, Bando K, Kikuchi Y, Tsujimoto K, Tanabe Y, Yoshida N, Tanaka H, Douchi S, Honda T, Odagaki M, Nakano H, Okada Y, Mori N, Hosomi K. Excessive excitability of inhibitory cortical circuit and disturbance of ballistic targeting movement in degenerative cerebellar ataxia. Sci Rep 2023; 13:13917. [PMID: 37626122 PMCID: PMC10457313 DOI: 10.1038/s41598-023-41088-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/22/2023] [Indexed: 08/27/2023] Open
Abstract
This study aimed to investigate abnormalities in inhibitory cortical excitability and motor control during ballistic-targeting movements in individuals with degenerative cerebellar ataxia (DCA). Sixteen participants took part in the study (DCA group [n = 8] and healthy group [n = 8]). The resting motor-threshold and cortical silent period (cSP) were measured in the right-hand muscle using transcranial magnetic stimulation over the left primary motor cortex. Moreover, the performance of the ballistic-targeting task with right wrist movements was measured. The Scale for the Assessment and Rating of Ataxia was used to evaluate the severity of ataxia. The results indicated that the cSP was significantly longer in participants with DCA compared to that in healthy controls. However, there was no correlation between cSP and severity of ataxia. Furthermore, cSP was linked to the ballistic-targeting task performance in healthy participants but not in participants with DCA. These findings suggest that there is excessive activity in the gamma-aminobutyric acid-mediated cortical inhibitory circuit in individuals with DCA. However, this increase in inhibitory activity not only fails to contribute to the control of ballistic-targeting movement but also shows no correlation with the severity of ataxia. These imply that increased excitability in inhibitory cortical circuits in the DCA may not contribute the motor control as much as it does in healthy older adults under limitations associated with a small sample size. The study's results contribute to our understanding of motor control abnormalities in people with DCA and provide potential evidence for further research in this area.
Collapse
Affiliation(s)
- Akiyoshi Matsugi
- Faculty of Rehabilitation, Shijonawate Gakuen University, Hojo 5-11-10, Daitou City, Osaka, 574-0011, Japan.
| | - Satoru Nishishita
- Institute of Rehabilitation Science, Tokuyukai Medical Corporation, 3-11-1 Sakuranocho, Toyonaka City, Osaka, 560-0054, Japan
- Kansai Rehabilitation Hospital, 3-11-1 Sakuranocho, Toyonaka City, Osaka, 560-0054, Japan
| | - Kyota Bando
- National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, 187-0031, Japan
| | - Yutaka Kikuchi
- Department of Rehabilitation for Intractable Neurological Disorders, Institute of Brain and Blood Vessels Mihara Memorial Hospital, Ohtamachi 366, Isesaki City, Gunma, 372-0006, Japan
| | - Keigo Tsujimoto
- National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, 187-0031, Japan
| | - Yuto Tanabe
- Department of Rehabilitation for Intractable Neurological Disorders, Institute of Brain and Blood Vessels Mihara Memorial Hospital, Ohtamachi 366, Isesaki City, Gunma, 372-0006, Japan
| | - Naoki Yoshida
- Okayama Healthcare Professional University, 3-2-18 Daiku, Kita-ku, Okayama City, Okayama, 700-0913, Japan
| | - Hiroaki Tanaka
- KMU Day-Care Center Hirakata, Kansai Medical University Hospital, Shinmachi 2-3-1, Hirakata City, Osaka, 573-1191, Japan
- Department of Physical Medicine and Rehabilitation, Kansai Medical University, Shinmachi 2-5-1, Hirakata City, Osaka, 573-1010, Japan
| | - Shinya Douchi
- Department of Rehabilitation, National Hospital Organization Wakayama Hospital, Hukakusamukaihatacyo1-1, Husimi-ku, Kyoto City, Kyoto, 612-8555, Japan
| | - Takeru Honda
- The Center for Personalized Medicine for Healthy Aging, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Masato Odagaki
- Maebashi Institute of Technology, Maebashi, Gunma Prefecture, Japan
| | - Hideki Nakano
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, Japan
| | - Yohei Okada
- Neurorehabilitation Research Center of Kio University, Koryo-cho, Kitakatsuragi-gun, Nara, 635-0832, Japan
| | - Nobuhiko Mori
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita City, Osaka, 565-0871, Japan
| | - Koichi Hosomi
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita City, Osaka, 565-0871, Japan
| |
Collapse
|